Illinois health insurance options for uninsured ?being set

ROCKFORD — Uninsured residents in Illinois can access a new pool of health insurance plans come Oct. 1 thanks to federal health care reform, and state officials are hustling to finalize details with less than six months to go before enrollments start.

ROCKFORD — Uninsured residents in Illinois can access a new pool of health insurance plans come Oct. 1 thanks to federal health care reform, and state officials are hustling to finalize details with less than six months to go before enrollments start.

The Affordable Care Act, which became law in 2010, aims to insure millions of people through federal and state insurance exchanges and marketplaces that offer consumers more health plan choices, putting people into bigger pools to reduce risks and costs. The law also includes a requirement that people be insured or pay a penalty starting in 2014.

Illinois was awarded a $115.8 million federal grant last week to fuel the next steps of finalizing the state marketplace. Insurance companies are submitting their proposals this month to be part of the marketplace, and state and federal officials will review those through July, said Mike Claffey, deputy press secretary of health care for Gov. Pat Quinn.

The state will roll out a massive public information campaign about the marketplace this summer because so much uncertainty still exists among people who will qualify to join it.

Nearly 500,000 people are expected to join the individual and small-business health exchanges in the first year, according to state estimates.

“People in general are not aware of the opportunities they’re going to have,” Claffey said. “For people who have not had access to insurance, that’s all going to change. They need to get educated and decide which plan is best for them.

“This is an exciting time, but we’ve got a big job in front of us. We don’t want people to be left out.”

Residents will qualify for subsidies to help them pay for marketplace insurance based on their income. Individuals and families with lower incomes will receive higher subsidies.

In-person helpers, called assisters and navigators, will be trained throughout Illinois communities — at places like medical facilities and social service agencies — to help people learn about their insurance options and how to enroll in the new system.

The new marketplace will shift the payer mix for hospitals and places like Crusader Community Health, a federally qualified community health center based in Rockford. The majority of Crusader’s patients have Medicaid insurance, but more than a third are uninsured.

Crusader President and CEO Gordon Eggers Jr. serves on one of the state committees involved with the marketplace, and he said officials are testing different models of health care delivery to help improve patient care.

“That’s a good thing, because right now, the medical system doesn’t work well enough toward common goals,” Eggers said. “There’s work being done to improve collaboration, and I applaud it.”

Eggers isn’t sure quite yet how the marketplace will change Crusader’s business, and he said that the fast-approaching October deadline creates added stress for local health care officials.

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“I think the state’s efforts are very well-intentioned, but (officials) are dealing with an incredibly complex subject,” Eggers said. “There are many stakeholders, but the biggest stakeholder is the patient.

“They’re trying to take the Affordable Care Act and its universal coverage and provide it in a way that’s cost-effective but still improves patient quality of health. I don’t believe they’re accepting the status quo on this.”